The next most important requirement is attentive observation. If we hope to
arrive at the truth we must not only be attentive to what the patient tells us,
and to what the nurse or family may impart, but we must observe closely the
appearance of the patient himself. Oft times the symptom which will lead us to
the remedy will be one which we may get by observation. The way the patient
lies, sits, walks, talks, conducts himself generally, the appearance of
discharges, the color of the eyes, hair, tongue, skin, etc, all have their place
and are of the greatest importance in our record. Upon your powers of
observation will depend not only the first image of your case but also your
success in conducting the case after the first prescription has been made.

Three
Mistakes

The last group of three relating to the taking of the case will be the three
mistakes made in examining the case, interruption of patient, asking direct
questions and making answers conform to some remedy we may have in mind.

A thing of the greatest importance in securing an image of a sickness is to
preserve in the simplest form what the patient tells you. Let him tell it in his
own language, and unless he digresses too much from the subject do not
interrupt, for by so doing you may lose a line of thought and may not be able to
get him back to it again.

Then do not ask direct questions. You must never put answers into your
patients' mouths. You need to know all these particulars but without asking
about it directly. Nine times out of ten the answer to a direct question will be
"yes" or "no;" such answers are without value and should not
be included in the record. Questions which give a choice of answers are also
defective.

Making answers conform to some remedy we may have in mind: a patient comes
in, tells us a few symptoms; we immediately think of a remedy and begin to ask
questions, and see if we cannot get enough evidence to convict him of Belladonna
, Arsenicum or whatever it may be. It is
surprising how well we can make the patient give us the symptoms we are looking
for, as well as how little evidence it takes for some of us to make the
conviction and give the remedy. We are more apt to blunder along this line if we
do not write out our cases. The mere writing of the symptoms helps us keep cool
and not pass hasty judgement. On page 206 Tafel's translation of Nature of
Chronic Diseases we find "The physician, can, indeed, make no worse mistake
than to consider too small the dose which I (forced by experience) have reduced
after manifold trials and which are indicated with every antipsoric remedy.
Secondly, the wrong choice of a remedy, and, Thirdly, the hastiness which does
not allow each dose to act its full time."

In remarking as to the cause of the second mistake, we will quote from the
same writings, on page 207, as follows:

"As to the second chief error in the cure of chronic diseases (the
unhomoeopathic choice of medicine) the homoeopathic beginner (many, I am sorry
to say, remain such beginners their life long) sins chiefly through inexactness,
lack of earnestness and through love of ease.

A difficulty may arise in those obscure cases the symptoms of which have been
masked by drugging, homoeopathic and otherwise, operations etc., so that these
cases only present a few common symptoms, which can only guide us to a group of
remedies in which the similimum must be found after exhaustive study of the
materia medica.

Many times in these cases before we can make any progress we must go back
through the life of the patient to childhood and note all symptoms which
preceded the pathological change that now obscures the image of your case.
"Symptoms that existed in childhood and those present before any pathology
existed are the corresponding symptoms of causes; as all causes are continuous
into effects. They give us an image of the case from causes to pathological
endings. These symptoms through childhood down to present are greatly important
and describe the progress of sickness."

How
to Find the Remedy

Having thus far outlined, in a brief way, the homoeopathic philosophy of the
first division of our Trinity, we will pass to the second angle, that of finding
the homoeopathically indicated remedy.

We believe that Homoeopathy is applicable to every curable case; the great
thing is to know how to find and apply it.

If we had nothing but the mass of symptoms as recorded in the materia medica
to help in the search for the single remedy which would cover the totality of a
complicated chronic case, it would indeed be a gigantic task, and the excuse of
many practitioners that they do not have the time to practice straight
Homoeopathy would be plausible, but we have in the repertory a valuable help
along this line, so that with practice and study the remedy may be found with
amazing rapidity.

That the technique of surgery is wonderful in its results when carefully
applied in its proper sphere is admitted by all physicians; that there is an
equally wonderful technique of scientific Homoeopathy must also be conceded or
the reason for our being, as homoeopaths, ceases to exist. That the science of
Homoeopathy is exact when applied by the use of the repertory has been proved
many times, and it will be my object today not only to demonstrate this truth,
but to try and give you an insight into the methods used, so that you may obtain
accurate scientific results easily and rapidly.

There are several complete repertories now published and the use of any one
of them will be of untold aid in finding the right remedy. When one has become
familiar with their arrangement all the time that is really consumed is in the
taking of the case.

When you have decided on the repertory you wish to use, confine yourself to
that one and completely master its arrangement, for the most rapid work and the
best results can only be obtained by the close study and working knowledge of
one. Personally, I can do the best and most rapid work with Kent's great work,
and my demonstration here will be taken from Kent's Repertory. Before
trying to use the repertory in your work read the headings of the general
rubrics from beginning to end and thus familiarize yourself with the arrangement
of the work, so that no time will be lost in looking for your symptoms. Only by
this and by constant use, can the repertory be a companion and helper.

Index to Arrangement of Kent's Repertory.

The Repertory is divided into the following thirty-seven sections, and are
found in the order given below:

the two most important sections are found first in the book (Mind)
and the Generalities which are last. The Alpha and Omega, the
beginning and the end.

Many of our chronic cases may be worked out from these two sections, from the
mentals and the generals, as when these are found to be covered by one remedy
the particulars which have been observed, and many of the common symptoms will
be found to fit in perfectly.

The same arrangement of each section is used throughout the book so that the
sequence once understood the finding of any rubric is very simple.

Restlessness in general, under which are found all those remedies which have
developed restlessness in the provers or removed the symptom clinically.

Then as to time. - Day time; morning; forenoon; afternoon; evening; night;
midnight, and at some special hour.

Then conditions under which restlessness has been observed (given in their
alphabetical order).

Aggravation in open air; driving out of bed; during chill; after dinner;
during heat; before, during and after menses; mental labor; during perspiration;
on waking; while sitting, and many others.

All these "modalities," when markedly present in a case, have great
selective value.

Let us now examine the section on Generalities. Here we find aggravations,
ameliorations, sensations and reactions of the patient, as a whole, to some
physical condition, as to pain in general.

Under these rubrics where nothing is specified, aggravation is understood.
The arrangement of the generalities is the same as throughout the other
sections.

First, time - morning; noon; night; at particular portion of, and at a
particular hour.

After time follow general conditions of patient as a whole in alphabetical
order. (Aggravations and ameliorations of various parts, head; eye; ear; nose;
face; stomach; chest; back; extremities; skin, etc., each is found in the
section referring to that part in particular.).

These general aggravations as found under this last section are as follows:
Better and worse from ascending; bathing; from cold; from wet and dry; from
position; form motion and rest; from pressure; from rubbing, etc.

Under aggravation from cold we have the following particulars: Cold in
general; cold air; becoming cold; cold, dry weather; entering a cold place;
tendency to take cold; cold, wet weather; cold feeling in blood vessels, bones
and inner parts. In looking for aggravations from wet and dry we find under wet:
Applications; getting wet; feet; head; perspiration; weather.

Aggravations and ameliorations as to weather conditions and time of year
under: Weather and Autumn, warm, wet weather (under Warm); Summer, Storms, as to
approach of and during; Spring, wet weather under Wet; Wind as to cold, warm
south, windy and stormy weather; cold, dry and cold, wet weather is found under
Cold.

Under this section we find the general character of Pain as to its onset and
its disappearance (gradual or sudden).

The character and frequency of the pulse are found in this section, and it is
grouped alphabetically as abnormal, frequent; intermittent; small, slow; full;
hard; soft; tense; weak, etc.

Perspiration as to general effect is found here as giving no relief;
aggravation after, amelioration after, and suppression of.

The characteristics and particulars of perspiration are found under that
Section, page 1257.

Aggravations from eating and drinking and from different foods and drinks, as
bacon; beer; bread; butter; fruit; meat; milk; pastry; tea, etc., the kinds and
condition of food; dry food; frozen food; hot; rich; salt; sweet; sour and warm
drinks and foods. These are all found under foods, while the desires, cravings
and aversions to various foods and drinks, hunger and thirst (these being
expressed by sensations from the stomach) are found under desires and aversions
in the stomach section, page 478.

The general aggravations and ameliorations before, during and after menses
are found in the generalities, while all important particulars and common
menstrual symptoms are found under Section Genitalia, Female,
page 712.

Many particulars having menstrual modalities will be found scattered through
all sections of the book, as, for instance, Headaches with menstrual
modifications, will be found under Head section. Abdominal distress modified by
menses under pain in back section, and son through all conditions.

Through everything throughout the book the same arrangement exists. The
aggravation or amelioration of patient as a whole is found under generalities,
but when referred to a part or an organ its aggravation or amelioration is
always found in its place under the section dealing with that particular part.

Pain, - One of the most frequent symptoms that the physician is requested to
remove is pain, and where to find the particular pain symptom in the repertory
is most bewildering, unless we are familiar with its arrangement. The plan here
is the same as elsewhere, which always carries one from what is more general to
what is most particular in its minutest detail. The first list of remedies will
be found to cover the time of occurrence. Second, all conditions under which the
pain is observed, these are arranged in alphabetical order so that any
particular condition may be readily found. Third, the locality of the pain.
Fourth, the character of the pain, and last, the part or direction to which the
pain extends. Keep this arrangement in mind and you will have no trouble finding
that for which you search.

To illustrate, let us examine pain in the extremities, which is the longest
and most complicated of all the pain sections.

First (page 1022) we have a list of remedies which have been found to have
symptoms of pain in extremities.

Following this are two short rubrics, Right and then Left, and Left then
Right. Then follows condition as to time, and then a long list of conditions
arranged alphabetically, under which pain in extremities is found, as, before
and during chill; after slight exertion; during menses; on motion; rheumatic;
syphilitic; wandering, etc.

Then follows a list which localizes in general, as Pain in Bones, in flexor
Muscles; Joints, Nails; Upper limbs; Shoulder; Upper arm; Elbow; Forearm; Wrist;
Hand; Fingers, and Thumb. These subdivisions of upper arm are all worked out
under same general arrangement, as to time, condition and extension to different
parts. Cold; heat; damp; dry; position and motion, as they aggravate and
ameliorate in particular, are all found in their alphabetical order.

Then follow the lower limbs, which are divided into their respective parts
and which are treated as to time, condition, etc., exactly as the upper limbs.
Thus having covered localities in general we proceed to deal with the character
of the pain in its various divisions.

Here, again, the whole extremities are analyzed, as under Pain Burning (page
1067); Burning generally, with its time and other conditions.

Burning in the joints and nails.

Burning in upper limbs generally, with time, conditions and extremities.

Burning in all the localities of upper limbs, in each instance with the time,
modalities, conditions and extension. Then follow the burnings in the localities
of the lower extremities arranged in the same way.

After one characteristic has been gone through exhaustively it passes on to
the next kind of pain each in alphabetical order.

Pain whether in head, stomach, abdomen, chest or other part of body in gone
through in this same general way into all its exhaustive finalities. This
arrangement is so important that it will bear repetition.

First, Pain Generally: As regards time and conditions, Always in
alphabetical order.

Second, Pain localized with regard to time, condition and extension.

Third. Character of pain generally with regard to time, condition and
extension.

Fourth. Character of pain as related to each locality in its turn
(alphabetically) with continued reference to time, conditions and extension.

It is well to remember one point in looking for symptoms in the repertory,
and that is, when you cannot find the symptoms as given in the language of the
patient, do not despair and throw down the book in disgust, but look for some
synonym until you find what you are looking for, and when you have found this,
make a cross reference in your repertory so it will be easier the next time.

Again, many fail to use the repertory because they think of symptoms in
pathological terms. Symptoms are recorded in the materia medica in the language
of the provers who were mostly laymen, and as the repertory is simply and index
to the materia medica the rubrics must be in their simple language.

From
Generals to Particulars.

Why do we work from generals to particulars?

If a case is worked out merely from particulars it is more than probable that
the remedy will not be seen and frequent failure will result. This is due to the
fact that the particular directions in which the remedies in the general rubric
tend have not been observed, and thus to depend upon a small group of remedies
relating to some particular symptom is to shut out the other remedies which may
have that symptom, although not yet observed. By working the other way, from the
generals to the particulars, the general rubric will include all the remedies
that are related to the symptom.

Before the physician can make any suitable homoeopathic prescription we must
take our case properly; this is true if we use a repertory or not, but is of the
greatest importance if the repertory is to be used. Hahnemann gives clear and
concise instructions for the taking of the case in the Organon, sections 83-104.

Write out all the mental symptoms and all the symptoms and conditions
pertaining to the patient himself, and search the repertory for the symptoms
that correspond to these. Then individualize the case [still] farther by using
the particular symptoms relating to the organs, sensations and functions, always
giving an important place to the time of occurrence of every symptom. In this
way we will before us an individualized symptom-picture, not of the disease we
wish to treat, but of the diseased patient we desire to cure.

Individualization of the symptom-picture and knowing which symptoms to give
the most attention form the hardest part of the prescriber's armamentarium to
acquire; and this process of logic, reasoning or whatever you may call it can
only be obtained by study and application. The homoeopathic physician must use
discrimination, must individualize things dissimilar in one thing and yet
similar in other ways. This is done by the generals, for without generals of a
case, no man can practice Homoeopathy; without these he will not be able to
individualize and see distinctions. After gathering all the particulars of the
case one strong general rules out one remedy and rules in another. If you know
your materia medica you will at once see how to get the generals and this will
enable you to distinguish the remedy best adapted to the constitution when two
or more remedies have one symptom in an equal degree. Then again, a patient may
bring out particular symptoms so strange that they have never been observed in
the remedy, but if the drug covers the generals, it will not only relieve those
special symptoms, but cure your case.

Remember this great truth, that the totality of the symptoms as represented
in the symptom picture of the prescriber will be an entirely different picture
from that made by the surgeon, diagnostician or pathologist. No man who can only
understand the morbid anatomy and pathognomonic symptom can make a homoeopathic
prescription. It is from this difference as to interpretation of the symptoms by
the different specialists that the reporting of cases cured by the prescriber
causes so much dissatisfaction. They want to know the exact pathological
condition of each organ that produced the symptoms which were removed by the
remedy; but the disease itself is only of benefit to the prescriber in helping
him to select his grades of symptoms.

After we have our individualized symptom picture before us, we are ready to
prepare the picture for repertory analysis. In order to analyze our case with
rapidity we must go about it logically; we must have a starting place and a
place to end. The start is made with the generals, and the particulars end it.

About the value of symptoms. Looking to Kent we find that he uses three
classes - generals, particulars and common, and in his repertory he divides each
into three grades - first, second, and third. The generals and particulars, you
must remember, have the greatest importance in our prescription.

Let us stop a moment and see what explanation he gives of these
classifications. Looking to his Lectures on Homoeopathic Philosophy we
find that as generals he includes all things that are predicated for the patient
himself. Things that modify all parts of the organism are those that relate to
the general state; the more thy relate to internals that involve the whole man,
the more they become general. Many common symptoms may run into generals and
particulars.

Things that relate to the ego are always general. The patient says, Doctor, I
am so thirsty; I burn so; I am so cold, etc.; the things he says he feels are
always general. His desires and aversions are general; menstruation is general,
for when a woman says I feel so and so during menses she has no reference to her
uterus or ovaries; her state, as a whole, is different when she is menstruating.
(Homoeopathic Philosophy, p 242.).

The general symptom as such are often not expressed by the patient or are not
always to be recognized as first to be so; but on examining a group or series of
particular organs we find a certain modality or feature which runs so strongly
through them that it may express the patient himself. Here we have a general
composed of a series of particulars. This most often happens under character of
pains, as cramping, burning etc., or in conditions associated with pains as
heaviness, numbness, etc. Here a symptom may be raised from a particular or even
a common to a common general.